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Midwifery in the United States: Fact Sheet

Crises of maternity care spending and poor maternal-infant health outcomes in the U.S.

  • The United States spends more than any other nation on health care, using almost half of all of the worldʼs health care dollars
  • $98 billion of health care spending in the U.S. goes towards the provision of maternity care
  • Despite large spending, the U.S. currently ranks 50th in the world for maternal mortality and 46th for infant mortality occurring during the first year of life

Midwifery care leads to improved health outcomes and cost-savings

  • Studies consistently demonstrate reduced maternal morbidity, equivalent perinatal mortality, decreased technological intervention at birth, enormous cost savings, and high client satisfaction rates associated with midwifery care

Improving maternal-child health outcomes: a comparison

  • Current U.S. cesarean rate is 32.8%
    • Midwifery cesarean rates range on average from 2.3% – 6.4%
  • Current. U.S. prematurity rate is 11.99%
    • Midwifery prematurity rates range on average from 1.4% to 1.7%
  • Current. U.S. low birth weight (<2500 grams) rate is 8.5%
    • Midwifery low birth weight rates range on average from 0.8% to 1.1%
  • Low birth weight and prematurity are the two leading factors in infant mortality
  • Significant health disparities exist in the U.S. among racial/ethnic minorities, low socioeconomic families, and other marginalized populations
    • Midwifery care can has demonstrated potential in improving health outcomes for vulnerable and disenfranchised populations.

Public health organizations recognize and support midwifery care for low-risk women, including:

  • American Public Health Association
  • World Health Organization
  • American College of Nurse Midwives
  • National Perinatal Association

The Midwives Model of Care™

  • The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes.

The Midwives Model of Care includes:

  • Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
  • Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
  • Minimizing technological interventions
  • Identifying and referring women who require obstetrical attention

The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

Copyright (c) 1996-2008, Midwifery Task Force, Inc., All Rights Reserved.

Homebirth Statistics

  • Number of homebirths in the United States: 29,650 (0.72% of all births in the U.S.)
  • Homebirth trends: 29% increase in homebirths from 2004 – 2009
  • Highest Rates of Homebirth by State: Montana (2.55%); Oregon (1.96%); Vermont (1.91%)
  • Homebirths by Attendant Type: Direct-entry Midwives (42.9%); Certified Nurse Midwives (19.5%); Physicians (4.9%); Other Attendant (32.9%)
  • Low Risk Profile for Homebirths: Preterm delivery (5.8%); Low Birth Weight (4.2%); Multiple deliveries (0.9%)

References

  • Central Intelligence Agency, 2011. CIA world factook. Central Intelligence Agency, Washington, D.C.
  • de Jonge, A., van der Goes, B., Ravelli, A., Amelink-Verburg, M., Mol, B., Nijhuis, J., Bennebroek Gravenhorst, J., Buitendijk, S., 2009. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births. International Journal of Obstetrics and Gynecology 116(9), 1177-1184.
  • Fullerton, J., Navarro, A., Young, S., 2007. Outcomes of planned home births: An integrative review. Journal of Midwifery and Womenʼs Health 52(4), 323-333.
  • Hamilton, B., Martin, J., Ventura, S., 2012. Births: Preliminary Data for 2010. National Vital Statistics Reports 60(2):1-25.
  • Health Management Systems, 2007. Midwifery licensure and discipline program in Washington State: economic costs and benefits. Health Management Associates, Washington D.C.
  • Janssen, P., Lee, S., Ryan, E., Etches, D., Farquharson, D., Peacock, D., Klein, M., 2002. Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia. Canadian Medical Association Journal 166(3), 315-323.
  • Johnson, K.C., Daviss, B.A., 2005. Outcomes of planned home births with Certified Professional Midwives: large prospective study in North America. British Medical Journal 330(7505), 1416-1422.
  • MacDorman, M.F., Matthews, T.J., Declercq, E., 2011. Homebirths in the United States: 1990 – 2009. NCHS Data Brief, 84, 1-9.
  • Murphy, P., Fullerton, J., 1998. Outcomes of intended home births in Nurse-Midwifery practice: A prospective descriptive study. Obstetrics and Gynecology 92(3), 461-470.
  • Schroeder, E., Petrou, S., Patel, N., Hollowell, J., Puddicombe, D., Redshaw, M., Brocklehurst, P., 2012. Cost effectiveness of alternative planned places of birth in woman at low risk of complications: evidence from the Birthplace in England national prospective cohort study. British Medical Journal 344(e2292), 1-13.
  • World Health Organization, 2010. Trends in maternal mortality: 1990 to 2008. World Health Organization, Geneva.

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